Seven Points To Know About Breastmilk Supply Issues

by Jessica Martin-Weber

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For the most part, if you decide to breastfeed, the experience will be: have boobs, feed baby. A process that has worked long enough to get us to this point in civilization, as mammals, generally speaking we will produce enough milk for our young. If everything is working normally, our breasts are going to make the milk our babies need. Lactating after giving birth is, for our species, normal, like breathing.

Which is well and good. But for as normal as it all may be sometimes there are issues with breathing and sometimes there are issues with lactation. Sometimes those issues are related to milk supply.

Before you worry about it or before you tell someone else to worry about it or not to worry about it, there are a few things that may be helpful to know. This is all just the tip of the iceberg, we’ll have more on this topic in the future but for now this is just a quick overview of breastmilk supply issues and not intended to be health care or replace medical care. If you are experiencing any problems with your supply, please see your healthcare provider and an experienced, professional skilled breastfeeding helper.

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1. Supply issues are real. Though biologically speaking it is normal to produce milk for our young, the fact is some will experience issues with supply. While they aren’t as common as it may seem, supply issues aren’t made up, they really do happen. Dismissing the concerns about supply can actually cause more supply problems as it may lead to feelings of isolation, failure, pain, grief, anger, and depression. If someone is concerned about their breastmilk supply, getting help is the right thing to do. They may discover that there is no evidence of supply issues and they can let go of their worry or they may find there is in fact a problem and take steps to address it to adequately care for their child(ren).

2. There is more than one type of supply issue. Often when talking about supply issues people assume it is low supply or not producing enough milk. Low supply is indeed a very concerning issue but it isn’t the only supply issue that may be experienced. Pumping supply, oversupply, and temporary supply issues (ovulation/period, illness, pregnancy, separation, etc.) are other supply issues that may present challenges for breastfeeding families. From poor weight gain to recurring mastitis to not reaching breastfeeding goals, the effects of supply issues cover a wide range and all of them matter.

3. Don’t borrow supply issue trouble. Yes, supply issues are real but before stressing about or trying to fix a supply issue, it is important to know if there is one (see related: Help, My Milk Supply Is Low, Or Is It?). This can be difficult to do if we don’t understand normal human lactation or normal baby behavior. For example, if you heard that I was pumping up to 24 ounce every pumping session at one point and you pumped 1-4 ounces in a session, you may think you have low supply (tip: this wouldn’t mean you have low supply- this means I had oversupply, one I manufactured to pump enough to skim the fat off to feed my very sick baby with two holes in her heart). Or if you found that your baby was extremely fussy and wanting to breastfeed every 30 minutes suddenly and you didn’t know what cluster feeding was and that it was common for babies to increase their feeding sessions during times of rapid growth, you may fear that your breasts suddenly weren’t making enough milk. Understanding the range of normal in human lactation is crucial!

4. There are multiple reasons for supply issues. Physiologically speaking, most breasts should have everything necessary to make plenty of milk (statistically less than 2% of breasts are equipped for adequate milk production) though there are some theories that this number is increasing. But a lack of milk making tissue isn’t the only cause of low supply. Other reasons for low supply include, but are not limited to, fluids in labor, tongue tie (frenulum restriction), high palate, hormone imbalance, diabetes, gut health, scheduled feedings, retained placenta, excessive pumping, ineffective sucking, health issues, some medication, early sleeping through the night, and the list goes on.

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5. Supply issues can create other issues. Yes, even perceived supply issues can create other issues. Confirmed supply issues even more so. Postpartum depression, anxiety, mastitis, gas, poor weight gain, breast tissue damage, unwanted and unnecessary supplementing, early weaning from the breast, etc. Those encountering issues with supply need more support and care on both a social level and from health care professionals.

6. Supply issues aren’t all doom and gloom. For starters, it doesn’t have to be all or nothing when it comes to feeding our babies. There are ways to address supply issues including methods to boost supply, supplement at the breast, train baby to suck more effectively, and reducing oversupply. Identifying the type of supply issue, the cause, and then the most effective methods for improving the supply issue (i.e. skin-to-skin helps low supply, decreasing pumping duration and frequency helps oversupply, hands-on-breast compressions and proper flange sizes can help pumping low supply, and magnesium can help temporary low supply caused by fertility cycles) along with supplementing techniques to encourage breastfeeding (i.e. paced feeding and at the breast supplementing) may all work together to turn things around.

7. There is support for supply issues. I often hear from breastfeeders with supply issues that they feel broken and alone. Supply issues can directly impact a parent’s confidence, causing them to question their competency in parenting when the most elemental aspect of parenting, feeding the child, is so difficult and overwhelming for them. While it can feel lonely when you’re dealing with supply issues, we don’t have to be alone. From social media groups to in person breastfeeding support groups to specialized breastfeeding helpers in the healthcare field, there is support for those experiencing supply issues. Working with a breastfeeding helper such as an IBCLC may help resolve the issue more quickly.

 

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Jessica Martin-Weber

Drawing from a diverse background in the performing arts and midwifery, Jessica Martin-Weber supports women and families, creating spaces for open dialogue. Writer and speaker, Jessica is the creator of TheLeakyBoob.com, co-creator of BeyondMoi.com, and creator and author of the children’s book and community of What Love Tastes Like, supporter of A Girl With A View, and co-founder of Milk: An Infant Feeding Conference. She co-parents her 6 daughters with her husband of 19 years and is currently writing her first creative non-fiction book.

To Supplement or not to Supplement Low Supply Giveaway

Low supply.  Of all the fears that new moms face with their babies, this one has to be in the top 5: what if I can’t produce enough breastmilk to feed my baby?  Which is just a cover for another fear: am I starving my baby??

How do you figure out if your little one is getting adequate nutrition from nursing when you can’t see how much milk they’re actually able to acquire in a feeding?  Should you just start taking supplements to boost your milk production, you know, just in case?

Before you jump into supplements, there are actually a few steps that you can take to help determine if your baby is getting what she/he needs from nursing.  Motherlove, long-time sponsor of TLB, has a couple of resources to share with you:

1. “Help, my milk supply is low! Or is it?” is a relational resource on TLB sponsored by Motherlove that explores the reasons why mothers think their supply might be low, provides an easy way to gauge if your supply is actually low, and lists a few resources to check out if you have determined that you do indeed have low supply.

  1. “I’ve got milk supply problems, now what?” provides a list of steps to take before starting to take supplements to boost your supply.  It also describes the many different options that Motherlove has developed once you’ve determined that supplements are what you need.  All of them are made with certified organic herbs, making them safe for you and your little one.

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Motherlove is offering a bottle of Motherlove milk supply supplements of your choice to 3 lucky Leakies!

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Good luck to everyone!  Please use the widget below to be entered.  The giveaway is open from February 2, 2015 through February 9, 2015.  A big thanks to Motherlove for their support of TLB and all breastfeeding women; please be sure to visit their Facebook page or follow them on twitter and thank them for their support of TLB and this giveaway opportunity.

This giveaway is restricted to U.S. entries only.

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Making Mama’s Milk Cookie Giveaway

As a mother of 5 who has struggled with low supply, Dori understands the desire to find ways to boost breastmilk supply.  Her solution: cookies!  She has figured out how to make cookies that are not only a pleasure to the palate, but also incorporate vitamins and herbs commonly believed to help in the production of breastmilk.  It is her desire to help mamas out in the same way her cookies have helped her in her breastfeeding journey.  Read on as Dori answers a few questions about her cookies below and enter to win a month supply of them.

TLB:  Tell us about the set-up you have for making your cookies?

Dori:  I have half of my kitchen changed like a small bakery. All of our Fresh Organic ingredients are in snap and lock containers. We also grind up our own Flax Seed, and Fenugreek Fresh which is kept in our fridge for the optimal freshness.

TLB:  How do you manage home life and baking?

Dori:  This isn’t easy at times….I have to always stay thankful that I am in business and able to help so many women! If I can continue looking at my glass as half FULL instead of half empty then I find a more positive outlook. I also have my husband home with me to take care of the kids- but planning meals around baking is hard so I have to plan the days before since I cannot use the kitchen/stove for anything except baking during most of the day.

TLB:  Your cookies are for mom and benefit her nursling, how do you suggest moms find time to take care of themselves and why?

Dori:  This is so very important, especially when baby is newborn and needs Mommy so much. When my babies were newborn, I always made sure that I had friends visit so I was even able to shower, or nap just to keep sane. I also believe in making sure new Mommies, and their families have meals delivered during the first 2 weeks after birth. I had this for the last 3 of my births and it was so helpful. Sometimes a nice bath with candle light does the trick for me 🙂

TLB:  What’s your favorite way to enjoy a Making Mamas Milk cookie?

Dori:  Fresh out of the oven- all gooey. I also LOVE having a cookie with my morning coffee/tea. I enjoy dunking them, as well as in the micro for a quick 3 seconds.

Dori is giving away a one month supply of Making Mama’s Milk cookies to two lucky Leakies.

Retail value $56.95

Here is a list of the cookies available this season:

  • Oatmeal Raisin (Dairy Free, and Vegan available too)
  • Oatmeal Chocolate Chip (Dairy Free, and Vegan available)
  • Oatmeal Butterscotch
  • Oatmeal Cranberry White Chocolate Chip
  • Oatmeal Pumpkin Spice (Dairy Free and Vegan available)
  • Oatmeal Pumpkin Spice with Chocolate Chips or Raisin (Dairy Free and Vegan available)

Leakies can keep up with Dori’s cookie selection on the MakingMamasMilk website.

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Good luck to everyone!  Please use the widget below to be entered, and check out makingmamasmilk.com for more information on Dori’s yummy cookies.  The giveaway is open from November 2, 2012 through November 9, 2012.  A big thanks to Dori and Making Mama’s Milk for their ongoing support of TLB and all breastfeeding women, please be sure to visit their Facebook page  or follow them on twitter (@MakingMamasMilk on Twitter) and thank them for their support of TLB and this giveaway opportunity.

This giveaway is open to international entries.

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Fairhaven Health Giveaway

The breastfeeding journey rarely happens without challenges.  Suzanne, from TLB sponsor Fairhaven Health, knows this personally, especially when it comes to dealing with low supply.  Today, Fairhaven Health is offering our TLB community a giveaway for those concerned about low supply.  Read on for details about this opportunity, to hear what Suzanne has to share about some of her own experience with low supply and answers some questions about Fairhaven Health.   

 

TLB: What kind of personal breastfeeding experience is behind the breastfeeding related products in your product line?

Suzanne: At Fairhaven Health, we support breastfeeding as the optimal feeding choice for mom and baby, and are honored to be able to support moms in reaching their breastfeeding goals. And, from personal experience, I know that even with lots of effort and intention, it is sometimes very difficult (but never impossible) to achieve the breastfeeding goals we set for ourselves. With my first born (Abigail, now 9 years old – see attached photo), I had high hopes of breastfeeding exclusively for six months or so, and then continuing  for as long as she wanted to, but at least until she turned 1 year. How hard could that be? But, during delivery, a few complications arose, and I ended up having a very late epidural. And, perhaps as a result of this late epidural (or for some other unknown reason), Abby had difficulty breastfeeding from the get go. Even after several visits with the lactation consultant and weeks of trying to establish a breastfeeding routine, Abby and I were unsuccessful. Because Abby never nursed successfully at the breast, I pumped exclusively and we fed her my breast milk from a bottle for nine months. As many women know, it is often difficult to maintain your supply when you are only pumping, and it was no different for me. I needed every herbal galactogogue available to help maintain my supply!  I am so grateful that these products existed when I was breastfeeding, and I love that Fairhaven Health is committed to providing such high quality products, like Fenugreek, Nursing Time Tea and Nursing Blend, to support today’s breastfeeding moms in reaching their breastfeeding goals.

TLB: What should we know about the new fenugreek tablets?

Suzanne: One of the inconveniences associated with taking Fenugreek and other herbal galactogogues (as if having supply issues is not inconvenient enough), is that research shows that these herbs are most effective when taken in large quantities. As a result, most brands of Fenugreek require many capsules each day. Fairhaven Health’s new Fenugreek product is a unique combination of organic Fenugreek seed powder and a concentrated Fenugreek seed powder extract (8:1), providing an equivalent dose of 2 grams of standard Fenugreek seed powder in just two capsules. This product is also great for what it doesn’t contain: no gluten, yeast, wheat, soy, dairy, animal products, artificial colors or artificial preservatives.

TLB: What do you think is most important for moms that are concerned about supply to know?

Suzanne: I think the most important thing for moms with supply issues to know is that it is actually quite rare for a nursing mom to not be able to eventually produce enough milk to feed her baby. Instead, it is often the case that supply issues are temporary, only present as mom and baby work to establish a routine in the first days, if the baby has trouble latching, or when mom or baby is ill. Once these kinks get worked out, supply typically increases. And, moms may see a decline in supply when they transition to work, when regular feedings are interrupted due to extended absences from the baby, or when exclusively pumping. It is during all of these times that moms can really benefit from natural galactogogues, such as Fenugreek, to boost their milk supply.

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Fairhaven Health is giving away this helpful prize to 5 lucky winners:

Three (3) bottles of Fenugreek dietary supplement  Retail value $45.00

 

 

Currently Leakies can find these and other great pregnancy and nursing products on the Fairhaven Health website.

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Good luck to everyone!  Please use the widget below to be entered, and check out fairhavenhealth.com for more products related to fertility, pregnancy, and nursing .  The giveaway is open from September 20, 2012 to September 27, 2012.  A big thanks to Suzanne and Fairhaven Health for their ongoing support of TLB and all breastfeeding women, please be sure to visit their Facebook page and thank them for their support of TLB and this giveaway opportunity.

This giveaway is open to US entries only.

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Help, my milk supply is low! Or is it?

By Tanya Lieberman, IBCLC

Ever wish your breasts had little ounce markings? If so, you’re not alone. One of the more confusing things about breastfeeding is determining how much milk you’re making. You can’t see how much is going into your baby, so how can you tell if your milk supply is enough for your baby?

On this page we share the best ways to determine if your milk supply is in fact low, and describe the many things that can make you think that your supply is low when it actually isn’t.

 

Below are some normal experiences that can trick you into believing that your supply is low:

“My baby wants to eat all the time.” It’s normal for babies to eat frequently, generally in the range of 8 to 12 times in 24 hours for many months. This means many hours of feeding a day, and it may feel constant at times. It’s also normal for babies to “cluster feed” at times during the day. If your baby is feeding significantly outside of the 8-12 times range, contact a lactation consultant or other breastfeeding support person.

“My breasts feel softer than they used to.” Toward the end of the first month of breastfeeding many women notice that their breasts have decreased from the size they were when their mature milk came in. This is normal, and does not indicate anything about milk supply.

“I don’t feel that ‘let down’ sensation.” Some women have a “let down” sensation when they make milk, and some don’t. It doesn’t seem to have any bearing on the amount of milk a mother makes, so don’t worry if you don’t feel anything.

“My baby suddenly wants to eat all the time.” Babies go through growth spurts. They do this in order to increase your milk supply to meet an increased need for calories. To do this, they go on a feeding rampage for a few days – eating more often than usual and sometimes acting unsatisfied and fussy after feedings. During a growth spurt it’s common to question your supply. After a growth spurt you’ll find that you have more milk than ever!

“I can’t pump very much.” Pumping output is usually not a good measure of milk supply. Why? Because your body doesn’t always make milk for the pump (it has to be tricked into believing that the pump is your baby!) and when it does the pump doesn’t remove milk as well as your baby does. So don’t gauge your milk supply based on your pumping output. You almost always have more than you pump.

“My baby is fussy when she nurses.” There are many causes of fussiness at the breast. And while hunger is one of them, your baby may be fussy because of gas, pooping, a flow that is too fast or too slow, or a host of other reasons. If you believe that your baby is fussy because he or she isn’t getting enough milk, or if the fussiness is causing you distress, consult a lactation consultant or other breastfeeding support person.

“My baby is suddenly waking up at night a lot.” Night waking can be due to hunger, but it can also be due to teething or “reverse cycling,” (when babies eat less during the day and more at night, often due to a change in routine like a return to work, or distracted behavior during the day).

 

Here’s how to tell if your milk supply is actually low:

1) Your baby’s weight. The best measure of whether your baby is getting enough milk is his or her weight gain.

If you are concerned about your milk supply, have your baby weighed and re-weighed using a baby scale. Scales will always be a little different, so be sure to compare only weights taken on the same scale. Except in critical situations, weight checks every few days or weekly is generally sufficient.

In the first three months of life babies gain an average of 1 ounce per day. That slows to at least approximately a half an ounce per day between 4 and 6 months. 

Occasionally your health care provider may suggest a “test weight,” in which your baby is weighed on a sensitive scale before and after a feeding (with the same clothes on) to determine how much milk the baby received at that feeding. This can give you a snapshot of a feeding, but be cautious in drawing conclusions from the data. The amount of milk babies take in at different feedings can vary widely, so bear this in mind if you do a test weight of your baby.

 

2) Diaper output. You can get a sense of how much your baby is taking in by what comes out. After the first few days, babies generally have at least three poops that are bigger than a quarter in size each day. This frequency may decline after several weeks. And your baby should have five very wet diapers per day. It can be difficult to measure output in very absorbent diapers, which is why your baby’s weight is considered the ‘bottom line.’

 

3) Swallowing. You may also take comfort in how much your baby is swallowing when nursing. This is not a definitive measure of your supply and should be confirmed with information about your baby’s growth, but a period of rapid swallowing (one swallow per one or two sucks) during a feeding shows you that your baby is getting milk. To check out your baby’s swallowing, listen for a ‘cah’ sound or a squeak or gulp, and look for a longer and slower movement of the jaw, often with a brief pause at the widest point. 

 

What to do if your milk supply is indeed low:

If your milk supply is low, be sure to get help from a lactation consultant (IBCLC) or other qualified breastfeeding support person. There are many steps you can take to build your milk supply, and these support people will be able to guide you through that process. You can find a lactation consultant by going to www.ilca.org.

 

Resources:

The Breastfeeding Mother’s Guide to Making More Milk. Diana West and Lisa Marasco, McGraw Hill, 2009.

La Leche League, International: www.llli.org

Kellymom: www.kellymom.com

Find a lactation consultant: www.ilca.org

 

Tanya Lieberman is a lactation consultant (IBCLC) who has helped nursing moms in hospital and pediatric settings.  She writes and produces podcasts for several breastfeeding websites, including MotherwearMotherlove Herbal Company, and the Best for Babes Foundation.  Tanya recently authored Spanish for Breastfeeding Support, a guide to help lactation consultants support Spanish-speaking moms.  Prior to becoming a lactation consultant she was senior education policy staff to the California legislature and Governor, and served as a UN civilian peacekeeper.  Tanya is passionate about supporting nursing moms, and especially to eliminating the barriers so many moms face in meeting their breastfeeding goals. She lives in Massachusetts with her husband, her 8 year old son and her 1 year old daughter.

This resource page was made possible by Motherlove Herbal Company.